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Theriac, treacle and sugar, from antidote to sweet


Among the thousands of medicines available to pre-modern patients, one stands out as a particularly unique and complicated pharmacological item: a substance called theriac. Its history spans from its initial use as is complex and maps the substance’s shift from an antidote for poisons in the ancient world to its shift into an eighteenth-century sweet confection. The word ‘treacle’ illustrates this shift nicely: it derives from and initially referred to the drug theriac, but eventually came to mean the sickly sweet substance of the modern world. Along the way, we witness how the history of sweeteners such as honey and sugar transformed an exclusive, expensive substance into an affordable saccharine treat.

Theriac even has its own legendary origins: we know the names of the supposed creators of the compound drug, one of them royal, King Mithridates VI of Pontus. In the first century BC, we are told, Mithridates was so concerned about being poisoned that he created a powerful antidote, which was eventually named Mithridatium in his honour. A century earlier, a recipe for an antidote to bites from poisonous animals appeared as a poem, Theriaca. These recipes became the basis of the expensive and complex medicine which continued for almost two millennia as the most famous drug to prevent poisons of various kinds.

Recipes for theriac often consisted of dozens of ingredients, many of them very expensive, and could take weeks (or longer) to prepare. Improvements were made to the original recipes, especially by the first-century AD figure Andromachus, who dedicated his revised antidote to the emperor Nero. Among the changes were the addition of honey as well as vipers, (seemingly a sort of sympathetic magic, by which the power of a poisonous creature was harnessed in the service of producing an antidote to poison). The quantity of sweetener varied, but often it outweighed the other ingredients considerably. In a the recipe attributed to Galen, ten litres (!) of honey are to be added. Over the course of the middle ages, theriac took on other healing powers, and was believed to be capable of doing much more than simply countering poisons including helping with fevers and sleep disturbances. By the middle of the fourteenth century, it acquired an important new role, as a medicine which was thought to help fight against the plague. As the epidemic we call the Black Death devastated large parts of Eurasia in the 1340s, theriac sadly, did not always live up to expectations.

While honey appeared to sweeten and bind the ingredients in theriac together, sugar became an increasingly important ingredient over the course of the drug’s history. Sugar was already known to Roman physicians as a substance which aided digestion. First cultivated in India, it only came into wider use in the Mediterranean via cultivation in Muslim controlled regions from the ninth century onward. Translations of Greek and Arabic medicine into Latin brought sugar and syrups (both words of Arabic origin) into Western European culture from the eleventh century. A mid-twelfth century text explains that ‘honey cane’(there was still some confusion over whether or not sugar differed from honey), arrived from the Islamic world (Spain, Sicily and the Holy Land) and was useful in cooling and moistening the body, and thus good for travelers and those suffering from fevers. As Sidney Mintz has argued, while sugar in the middle ages was prohibitively expensive for all but the aristocracy, the early modern expansion of sugar cane production in the Caribbean and elsewhere through the use of slave labour had increased the supply and drastically reduced the cost of sugar by the turn of the nineteenth century.

As the recipes for theriac evolved, the use of the drug was also expanding. For example regional variants of the drug were abundant: theriacs associated with London, Paris, Montpellier, Flanders, Genoa and especially Venice claimed unique abilities and stirred geographical rivalries. Under Cromwell’s Commonwealth, the radical medical reformer Nicholas Culpeper (1616-1654) brought theriac to a larger audience by translating into English a recipe for ‘Theriaca Andromachi’ or ‘Venice Treacle’. The recipe consisted of several dozen ingredients and ended with a noteworthy amount of honey - three times the weight of the dry ingredients. At this point in time, Venetian theriac was still thought to be useful against poisons and pestilence but had become a sweet substance to be ingested regularly each morning: ‘A man may safely take two drams of it in a morning, and let him fear no harm.’ Culpeper also notes that treacle produced a ‘terrible mess’ as it was prepared. In English the word ‘treacle’ first appeared in the fifteenth century and initially was simply the English equivalent of theriac, with all of its medical connotations of protection against poison and plague. Eventually by the eighteenth century it came to mean a general cure-all and increasingly began to refer to a sweet confection (the word ‘confection’ could refer to any medical, alchemical, or culinary gathering of ingredients) with little reference to medicine. This shift was in part assisted by a (literary) attack in the 1740s which questioned theriac’s efficacy. By the nineteenth century, treacle had become almost entirely the preserve of cooking, and was associated with the sticky syrupy substance used in puddings today. From antidote to sweetener, the history of theriac and treacle nicely illustrates the complex relation between medicinal drugs and food and reveals how radically substances and words can change over centuries of popular use.


Culpeper, Nicholas. A Physical Directory, or a Translation of the Dispensatory made by the College of Physitians of London. London: Peter Cole, 1649.

Fabbri, Christiane Nockels. ‘Treating Medieval Plague: The Wonderful Virtues of Theriac.’ Early Science and Medicine 12 (2007) 247-83.

Griffin, J.P. ‘Venetian treacle and the foundation of medicines regulation.’ British Journal of Clinical Pharmacology 58 (2004) 317-25.

Matthaeus Platearius. 'Circa Instans'. Translated in Katherine Jansen, et al. Medieval Italy: Texts in Translation. Philadelphia: University of Pennsylvania Press, 2009.

Mintz, Sidney. Sweetness and Power: The Place of Sugar in Modern History. New York: Penguin Books, 1985.

William MacLehose

Dr William MacLehose is a historian of medieval medicine and religion, and is Lecturer in History and Philosophy of Science at UCL. He is the author of A Tender Age: Cultural Anxieties over the Child in the Twelfth and Thirteenth Century and co-editor of Imagining the Brain: Episodes in the History of Brain Research. He is currently working on a study of medieval views of sleep and its pathologies.